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Helmets in collision sports

Health Factors: Community Safety
Decision Makers: Community Members Educators Nonprofit Leaders
Evidence Rating: Some Evidence
Population Reach: 1-9% of WI's population
Impact on Disparities: No impact on disparities likely

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Helmets absorb, dissipate, and reduce impact forces to an athlete’s head and brain during collisions between players or a fall to the ground. Helmet design and specifications vary by sport and athlete’s position; helmets typically include a comfort liner, an impact energy attenuating liner, a restraint system, and a shell. Some sporting organizations provide standards regarding helmet design, construction, level of protection, stability, and vision along with impact test criteria and requirements (McIntosh 2011a). 

Expected Beneficial Outcomes

Reduced sports-related concussion
Reduced head injury

Evidence of Effectiveness

There is some evidence that wearing helmets in collision sports reduces concussion (Bonfield 2015, Daneshvar 2011, Emery 2017). However, effects vary by sport. Additional evidence is needed to confirm effects.

Helmet use has been shown to reduce concussion and severe head injuries for recreational skiers and snowboarders (Bonfield 2015, Daneshvar 2011, Russell 2010). Wearing helmets may reduce high school football players’ likelihood of concussion when helmets fit appropriately (Schneider 2017, Emery 2017). The design and model of football helmet appears to affect concussion risk among high school and college football players in some cases (Emery 2017, Bonfield 2015, McGuine 2014).


United States

High school and college football players are required to wear helmets that meet the National Operating Committee on Standards for Athletic Equipment standards (Levy 2004). USA Hockey mandates use of helmets approved by the Hockey Equipment Certification Council (UECC) with an expiration date of UECC certification on a sticker on the helmet (USA Hockey-Equipment). International Ski Federation (FIS) and US Ski and Snowboard Association require all players in alpine competitions and official training to wear a helmet that meets the FIS standards (USSA-Helmet). 

Citations - Description

McIntosh 2011a* - McIntosh AS, Andersen TE, Bahr R, et al. Sports helmets now and in the future. British Journal of Sports Medicine. 2011;45(16):1258-1265. Accessed on May 17, 2018

Citations - Evidence

Bonfield 2015* - Bonfield CM, Shin SS, Kanter AS. Helmets, head injury and concussion in sport. The Physician and Sportsmedicine. 2015;43(3):236-246. Accessed on May 17, 2018
Daneshvar 2011 - Daneshvar DH, Baugh CM, Nowinski CJ, et al. Helmets and mouth guards: The role of personal equipment in preventing sport-related concussions. Clinics in Sports Medicine. 2011;30(1):145-163. Accessed on May 17, 2018
Emery 2017* - Emery CA, Black AM, Kolstad A, et al. What strategies can be used to effectively reduce the risk of concussion in sport? A systematic review. British Journal of Sports Medicine. 2017;51(12):978-984. Accessed on May 17, 2018
McGuine 2014 - McGuine TA, Hetzel S, McCrea M, Brooks MA. Protective equipment and player characteristics associated with the incidence of sport-related concussion in high school football players: A multifactorial prospective study. The American Journal of Sports Medicine. 2014;42(10):2470-2478. Accessed on May 17, 2018
Russell 2010 - Russell K, Christie J, Hagel BE. The effect of helmets on the risk of head and neck injuries among skiers and snowboarders: A meta-analysis. Canadian Medical Association Journal. 2010;182(4):333-340. Accessed on May 17, 2018
Schneider 2017* - Schneider DK, Grandhi RK, Bansal P, et al. Current state of concussion prevention strategies: A systematic review and meta-analysis of prospective, controlled studies. British Journal of Sports Medicine. 2017;51(20):1473-1482. Accessed on May 17, 2018

Citations - Implementation

Levy 2004* - Levy ML, Ozgur BM, Berry C, Aryan HE, Apuzzo MLJ. Birth and evolution of the football helmet. Neurosurgery. 2004;55(3):656-662. Accessed on May 17, 2018
USA Hockey-Equipment - USA Hockey. Rulebook: Rule 304. Protective equipment. Accessed on May 17, 2018
USSA-Helmet - US Ski and Snowboard Association (USSA). USSA and FIS helmet regulations. October 2015. Accessed on May 17, 2018

Page Last Updated

May 10, 2018

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